Grand Rounds Blog

Grand Rounds is committed to partnering with employers to connect their employees with the highest quality physicians. In evolving our physician quality algorithm, our Data Science team is continually evaluating physicians’ clinical practice patterns, and the results paint a stark portrait of medicine today.

BREAST CANCER: Not all oncologists are created equal.

How many of your employees were diagnosed with breast cancer this year?

Studies suggest that the lifetime risk of developing breast cancer is 1 in 8 for women in the United States. But a diagnosis of breast cancer doesn’t necessarily mean an inevitable path to chemotherapy and its toxic side effects.1

Consider this fact: Research suggests that genomic testing could help up to 40,000 American women with early-stage breast cancer avoid unnecessary chemotherapy.2

The development of genomic tests that can identify which cancer patients can safely forgo chemotherapy is a major breakthrough in personalized medicine. Despite this, many oncologists continue to recommend chemotherapy to breast cancer patients without ever conducting the tests to see whether such treatment is likely to provide any clinical benefit. One recent study found that only 27% of eligible breast cancer patients received genomic testing to determine whether chemotherapy was appropriate.3

Our analysis indicates that whether a woman with breast cancer receives one of these genomic tests, called Oncotype DX, varies substantially depending on the quality of the oncologist they see. Patients who see oncologists ranked in the top 10% nationally are more than twice as likely to receive Oncotype DX testing than patients who see oncologists ranked in the bottom 10%.

1 in 8 woman in the U.S. can expect to develop breast cancer in their lifetime.

Even with this test, deciding whether to undergo chemotherapy can still be a very difficult decision. However, this analysis suggests that many women are missing out on the opportunity to make informed decisions based on the valuable information that the test can provide. While the Oncotype DX test has been available for more than a decade, it appears that many oncologists are still lagging in their adoption of this medical advancement. For women with breast cancer, the choice of which oncologist to see can therefore have dramatic impact on the care they receive.

Using more than seven billion data points, Grand Rounds has assessed over 96% of practicing physicians in the United States to identify the highest quality doctors in each specialty. As an employer, partnering with Grand Rounds can help your employees find physicians with the skill and judgment needed to guide your employees on the best clinical path.





  1. “Breast Cancer Risk and Risk Factors,”, June 2016
  2. “Gene Tests Identify Breast Cancer Patients Who Can Skip Chemotherapy, Study Says,” New York Times,, August 2016
  3. “Under-Utilization of Gene Expression Profiling For Early Stage Breast Cancer in California,” National Center for Biotechnology Information,, April 2016
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